After a lot more reading (Borchani, 2015), I believe the story is more hopeful than Sam and I thought, but it is still incomplete.
First, there are numerous ways to build a multivariate model out of univariate ones. Borchani, et al. calls them "Problem Transformation methods". I call them hacky; some of them had actually crossed my mind before I even asked this question, but I went looking for a more theoretically solid way instead of trying them. Essentially, these methods consist of layering univariate models so some take the outputs of others as inputs. The resulting architectures can be characterized as either "stacking" or "chaining". There are some interesting ideas and sophisticated structures, but ultimately:
"Considering the model's predictive performance as a comparison criterion, the benefits of using multi-target regressor stacking [MTRS] and regressor chains [RC] (or ERC and the corrected versions) instead of the baseline single-target approach [where you train independent univariate learners on each output dimension] are not so clear. In fact, in Spyromitros-Xioufis et al., an extensive empirical comparison of these methods is presented, and the results show that single-target methods outperform several variants of MTRS and ERC...In particular, the benefits of MTRS and RC methods seem to derive uniquely from the randomization process and from the ensemble model."
So that's not great. What can be done?
Thankfully there are other methods the author calls "Algorithm Adaptation methods", which can be further broken down in to "Statistical methods" and true ML algorithm adaptations, the kind of thing I was originally looking for.
Statistical methods are really a generalization of linear regression:
Statistical methods could improve notably [on] the performance ...[of] single-target regression, but only if...a relation among outputs truly exists and a linear output-output relationship (in addition to a linear input-output relationship) is verified. Otherwise, using these statistical models could produce a detriment [to] predictive performance. In particular, if we assume that the $d × p$ [where $X$ lives in $ℝ^{p}$ and $Y$ in $ℝ^{d}$] matrix of regression coefficients has reduced rank $r < min(d, p)$ [as is a common feature to the statistical models discussed] when in reality it possesses a full-rank, then we are obviously wrongly estimating the relationship, and we lose some information.
Like statistical models, Multi-Output Support Vector Regression "mainly rel[ies] on the idea of embedding the output space. [Both MO-SVR and statistical models] assume that the space of the output variables could be described using a subspace of lower dimension than $ℝ^{d}$." Note embedding makes sense if (1) $p < d$ ("an embedding is certain") or (2) the output space has structure (in a subspace or on a manifold). But unlike vanilla statistical models, MO-SVR can handle nonlinear cases. (Though one should use the higher-bias, lower variance vanilla models when dealing with a linear problem, as nonlinear models like to overfit in such scenarios.)
"MO-SVR [is], in general, designed to achieve a good predictive performance where linearity can not be assumed."
The other major, successful true ML adaptation is Multi-Target Regression Trees, which is a lot like ordinary decision trees except they use a different notion of "purity" to decide splits and calculate multidimensional answers at the leaves. Scikit-Learn actually implements this in DecisionTreeRegressor and ExtraTreeRegressor. I am not yet convinced these models are actually better at making predictions, but they have the advantage of being simpler, since they can be composed of fewer trees or even a single tree.
"Multi-target regression trees...are based on finding simpler multi-output models that usually achieve good performance (i.e. comparable with single-target approach)."
There are a couple of other things: "Kernel methods" are related to MO-SVR, and "Rule methods" are related to trees, but that's it. According to the authors: "To the best of our knowledge, there is no other review paper addressing the challenging problem of multi-output regression." That was 2015. The story may have changed slightly, but I have not been able to discover any methods aside from these, which is shocking. In Algebra II we learned about basic regression, coming up with a function to map a single input to a single output. At the institute we learned how Statisticians and Computer Scientists have come up with multifarious methods to map from many inputs to a single output. The next stage of the evolution is clear, but most algorithms remain un-generalized.